Individual
INDIA PETTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5530 WISCONSIN AVE, SUITE 1660, CHEVY CHASE, MD 20815-4404
(301) 657-9876
Mailing address
7250 PARKWAY DR STE 500, HANOVER, MD 21076-1343
(443) 949-0814
(443) 949-0825
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0005125
MD
363AS0400X
Surgical Physician Assistant
C0005125
MD
Other
Enumeration date
08/23/2013
Last updated
01/27/2023
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